Àá½Ã¸¸ ±â´Ù·Á ÁÖ¼¼¿ä. ·ÎµùÁßÀÔ´Ï´Ù.
KMID : 0368120080380070366
Korean Circulation Journal
2008 Volume.38 No. 7 p.366 ~ p.373
The Effects of Rosuvastatin on Plaque Regression in Patients Who Have a Mild to Moderate Degree of Coronary Stenosis With Vulnerable Plaque
Hong Young-Joon

Jeong Myung-Ho
Chung Jong-Won
Sim Doo-Sun
Cho Jung-Sun
Yoon Nam-Sik
Yoon Hyun-Ju
Moon Jae-Youn
Kim Kye-Hun
Park Hyung-Wook
Kim Ju-Han
Ahn Young-Keun
Cho Jeong-Gwan
Park Jong-Chun
Kang Jung-Chaee
Abstract
Background and Objectives: Intensive lipid-lowering therapy with statins improves the clinical outcomes and patient survival and it reduces the progression of atherosclerosis. Intravascular ultrasound (IVUS) has been used for calculating the plaque volumes to evaluate the mechanisms that may be involved in the progression or regression of coronary artery disease. We used serial IVUS exams to assess the efficacy of rosuvastatin on plaque regression in angina patients who had a mild to moderate degree of vulnerable plaque burden.

Subjects and Methods: This study was a prospective, randomized, comparative study for lipid lowering therapy with using rosuvastatin 20 mg or atorvastatin 40 mg. IVUS was performed during the baseline coronary angiography and it was repeated after 12 months of treatment. The efficacy parameters included the changes in the atheroma volume and the lipid pool size as determined by IVUS. A total of 45 lesions in 30 patients were analyzed (rosuvastatin: 24 lesions in 16 patients vs. atorvastatin: 21 lesions in 14 patients).

Results: The low density lipoprotein (LDL)-cholesterol level was reduced from 121¡¾45 mg/dL to 65¡¾25 mg/dL in the rosuvastatin group (a 46% decrease, p<0.001), and from 127¡¾37 mg/dL to 72¡¾26 mg/dL in the atorvastatin group (a 43% decrease, p<0.001). The total atheroma and vessel volumes were significantly decreased, whereas the lumen volume was significantly increased from baseline to follow-up in both groups (for the rosuvastatin group: the total atheroma volume, 252¡¾80 to 246¡¾79 mm3, p<0.001; the vessel volume, 555¡¾158 to 553¡¾130 mm3, p<0.001; the lumen volume, 303¡¾91 to 307¡¾92 mm3, p<0.001, and for the atorvastatin group: the total atheroma volume, 288¡¾98 to 283¡¾98 mm3, p<0.001; the vessel volume, 607¡¾165 to 604¡¾166 mm3, p<0.001; the lumen volume, 319¡¾71 to 321¡¾73 mm3, p<0.001). The follow-up LDL-cholesterol level was correlated with the change in the total atheroma volume (r=0.577, p<0.001), the change in the percent atheroma volume (r=0.558, p<0.001) and the change in the lipid pool size (r=0.470, p=0.001).

Conclusion: Both rosuvastatin 20 mg and atorvastatin 40 mg could contribute to the regression of lipid-rich plaque. The follow-up LDL-cholesterol level is related to the regression and stabilization of vulnerable coronary plaque.
KEYWORD
Atherosclerosis, Lipids, Statins, HMG-CoA, Ultrasonics
FullTexts / Linksout information
 
Listed journal information
SCI(E) ÇмúÁøÈïÀç´Ü(KCI) KoreaMed ´ëÇÑÀÇÇÐȸ ȸ¿ø